Obama called bully by Republicans over ACA push

(Bloomberg) -- Anne Filipic, who helped Barack Obama secure a turning-point victory in the 2008 Iowa caucuses, plans to send thousands of volunteers door-to-door this year on a new campaign: to help the president sell the Affordable Care Act to the nation’s 50 million uninsured.

First, though, the organization she leads, Enroll America, must deal with fallout from Republicans who say the Obama team is pressuring companies such as drugmaker Johnson & Johnson to back an outreach push that could cost as much as $100 million.

Enroll America is an umbrella organization for groups that will promote the ACA’s insurance exchanges, new online marketplaces where millions will shop for subsidized coverage starting Oct. 1. Health and Human Services Secretary Kathleen Sebelius said this week that she talked with J&J and two other health companies about supporting the enrollment push, considered a key to the law’s success.

That Sebelius has “admitted to having pressured the very companies her agency regulates to get behind a nongovernment group in support of Obamacare raises even more ethical and legal questions,” said Senator Orrin Hatch, a Utah Republican. “That’s bullying plain-and-simple.”

Sebelius told a House committee yesterday she didn’t solicit financial contributions for Enroll America from J&J or the other health-care companies, Kaiser Permanente and Ascension Health. The secretary supervises agencies including the Food and Drug Administration, which regulates drug and device makers, and the Centers for Medicare and Medicaid Services, which oversees activities of health insurers and hospitals.

Republican criticism

Republicans have been stepping up their criticism of the administration on issues ranging from the killing of the American ambassador to Libya in September to the Internal Revenue Service’s admission last month that at least some of its employees targeted conservative organizations. Advocacy groups such as FreedomWorks and Restore America’s Voice have vowed to mount campaigns to discourage enrollment when the insurance exchanges open.

The debate over Sebelius’ tactics “simply misses the point,” Filipic, 31, a former White House aide, said in a statement. “The bottom line is that a tremendous opportunity is going to be available to millions of Americans starting in October and Enroll America is working with a broad range of organizations -- from consumer advocates, to the faith community, to health care stakeholders -- to ensure that consumers have the information they need.”

Early backers

At least 25 million people who lack health insurance are expected to gain coverage by 2023 because of the ACA, according to the Congressional Budget Office. The law allows states to expand Medicaid to cover anyone earning close to poverty wages. For higher-income people who don’t get coverage through their jobs, the law sets up government-run marketplaces to sell private insurance policies, in many cases with subsidies for monthly premiums and cost-sharing.

Kaiser Permanente, an Oakland, California-based nonprofit hospital and insurance company, and Catholic hospital network Ascension Health, were “early partners” and financial supporters of the group, said Filipic, who served as field director for the Obama campaign in the Iowa Democratic caucus and was deputy director of public engagements in the White House.

While the political debate continues, the law’s backers are gearing up for the exchanges’ debut. Enroll America is helping to lead the charge, employing data-mining and marketing tactics honed during political campaigns to find and motivate as many potential enrollees as possible.

The group’s chairman, Ron Pollack, said in November that he hoped Enroll America would raise as much as $100 million for its work from private donors including health care companies and foundations. Filipic, in an interview at her Washington offices, said she was happy with the group’s funding while declining to provide a firm financial target.

“This is a pretty big task ahead of us in terms of the lack of awareness out there” about the law, she said. “We realize that. What we’re trying to do is reach people where they are, make this as easy as possible for them.”

Historical pattern

Sebelius had previously acknowledged asking others to support the effort, including the Robert Wood Johnson Foundation, based in Princeton, New Jersey, and Kansas City, Missouri-based tax preparer H&R Block Inc., which hopes to make a business of advising clients on the health law.

She told the congressional committee this week that helping Enroll America was no different than efforts under former President George W. Bush to get assistance promoting a 2003 expansion of Medicare’s drug program.

Whenever the government has enacted expansions of health benefits, “there has been a very extensive outreach effort from the secretary to private groups,” she said. From the time the Affordable Care Act was passed, she said, the Obama administration was aware “that the federal government couldn’t possibly take on the whole task, that this was an all-hands-on-deck activity.”

Ernie Knewitz, a spokesman for New Brunswick, New Jersey-based J&J, confirmed in an e-mail that the company had gotten a call from Sebelius in April. John Nelson, a spokesman for Kaiser Permanente, said in an e-mail that the company supports “the goal of encouraging every eligible American to enroll in coverage.”

Trudy Hamilton, a spokeswoman for St. Louis-based Ascension, didn’t return a phone call left at her office.

Filipic’s role

Enroll America received early support from insurers including UnitedHealth Group Inc. and Aetna Inc., Pollack said. Its partners include other companies that might benefit from expanded coverage, such as generic drugmaker Teva Pharmaceuticals Ltd. and drugstore chain CVS Caremark Corp.

Filipic joined Enroll America in January after leaving the administration. She’d previously served as deputy executive director at the Democratic National Committee and was a field director in Iowa when then-candidate Obama won a pivotal primary over Democratic rival Hillary Clinton.

Enroll America has expanded from eight staff members to 40 since Filipic arrived. So far, the group has focused on figuring out just who the uninsured are and how to reach them, she said. The group surveyed about 1,800 people last year and has run focus groups to test marketing messages.

Finding customers

By the end of the month, it hopes to have a statistical model that will help volunteers pinpoint which doors to knock on. Neighborhood visits should begin after that, along with community events designed to highlight the law’s benefits.

The goal is to use advocacy groups’ resources as efficiently as possible, Filipic said. Enroll America knows that two-thirds of the uninsured Americans live in just 13 states, most in about 100 counties. Still, even counties with high rates of insurance coverage may have thousands of residents eligible for the law’s subsidies. For example, in the Houston area, about 120,000 people without insurance live in counties where most residents have coverage, she said.

The group wants to provide tested talking points to health clinic workers, doctors, owners of barber shops and beauty salons, among the “trusted messengers” who influence people, she said. And Enroll America has learned the most trusted source of information for 20-something men -- the kind of young, healthy customers sought by insurers -- are their mothers.

“It’s really a very segmented approach,” Filipic said. “We’re trying to reach the moms, give them the information they need so that when they are sitting down at the dinner table they can be sharing information in the most effective form, and I think that’s going to be where a lot of the power of this comes from.”